Study Title: The Impact of Automated Reminders Linked to a Personal Health Record on Adherence with

Glaucoma Medications:

The Automated Dosing Reminder Study (ADRS)

MEMOTEXT Corporation Trial with Johns Hopkins UniversityWilmer Eye Clinic –

Funded by Microsoft BeWell Fund

www.memotext.com1877-MEMO.TXTTwitter @memotext

2

What Really Works?!

• What is MEMOTEXT?• Overview: Automated Dosing

Reminder Study (ADRS)• Problem/Hypothesis• Methods• Moving the Needle• Lessons Learned ~ Organic solutions

MEMOTEXT is an:• Iterative methodology• Interactive dialogue• Inference based

…speech, mobile and social media patient adherence solution.

Stage of

ChangeRECRUITMENT

Personal History

Disease/ Med

LiteracyASSESSMENT

Self Efficacy

Depression

INTERVENTION

Locus of Control

RE-ASSESSMENT

What is MEMOTEXT?

3 of 10

What really works?!

This project received funding from the Microsoft HealthVault Be Well Fund.

Lead by: Michael V. Boland, MD, PhDAssistant ProfessorDirector of Information TechnologyWilmer Eye Institute and Health Sciences InformaticsJohns Hopkins University

Johns Hopkins University: Approached MEMOTEXT® to provide an automated, customized and interactive adherence solution for glaucoma daily medication - a study entitled "The Impact of Automated Dosing Reminders on Medication Adherence using HealthVault“ (ADRS).

Launched: June 2009

Prelim results presented at American Glaucoma Society March 2011Automated reminders linked to a personal health record are a practical option to improve adherence

www.memotext.com

4 of 10

Problem: Non-compliance to Glaucoma medications leads to severe complications.

• Problem: cost- staff time to interact with patients

• Problem: lack of patient education • Problem: poor adherence in almost half of

study patients• Problem: patients self –reporting after the

fact is not reliable• Problem: Lack of patient/family control

Hypothesis:The Automated Dosing Reminder Study tested the hypothesis that automated, telecommunication-based reminders can improve adherence with glaucoma medications in patients known to have poor adherence.

www.memotext.com Glaucoma adherence study overview

5 of 10

Recruitment Channel: JHU Research / Wilmer Eye Clinic directly into Microsoft HealthVault

Poor adherence is defined as taking < 75% of doses during the monitored period.

N= 428 glaucoma patients treated with once daily therapy.

Subjects were monitored electronically for 3 months (MEMS, AARDEX group).

White coat effect: adherence rate was calculated from 2 weeks after the baseline visit until 2 weeks before the follow-up visit.

• Monitor Adherence

3 months

• Poor Adherence

• Good Adherence

Randomize

• MEMOTEXT group

• Control group

3 months

www.memotext.com Methods

6 of 10

Recruitment/EnrolmentPatients selected

1. Medication: Travatan, Xalatan and Lumigan

2. Frequency (daily/weekly)3. Media (sms/IVR)4. Time of message(s)

www.memotext.com Methods cont.. enrolment

7 of 10

Patients receive weekly, bi-weekly or daily

messages via voice / SMS

Acknowledge / confirm action

Snooze call Repeat this message

49.02 % of voice messages were conf./acknowledged in real time. 2% of calls were snoozed and called back.

SMS and IVR Calls

8 of 10

FINAL RESULTS Initial (%) Final (%) p

Control 49 ± 26 50 ± 31 0.83

Intervention 51 ± 19 67 ± 19 0.003

Moving the needle

9 of 10

Avg. Age 69

Sex (% female) 52

Ethnicity (%)

European 59

African 34

Asian 5

Hispanic 1

Other 1

• Medication adherence is a problem in a significant population of glaucoma patients

• Automated reminders linked to a personal health record:– Are a practical option to improve adherence– Allow patient or family control over reminders– Significantly improve adherence with daily medications

• A simple, elegant intervention increased adherence by 16%

• Recommendation was to develop method to predict non-adherent patients.

Do the difficult things while they are easy and do the great things while they are small... Lao Tzu

Stage of

ChangeRECRUITMENT

Personal History

Disease/ Med

LiteracyASSESSMENT

Self Efficacy

Depression

INTERVENTION

Locus of Control

Summary…From simple messaging to intelligent dialogues.

10 of 10

• Find us to learn about how we create self-learning SMS, speech and social adherence interventions.

• www.memotext.com• amos@memotext.com• www.Twitter.com/memotext • 877-MEMO.TXT• Txt or call me: 416-520-3301

Keep in touch!

And they all lived happily ever after…